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Friday, December 3, 2021

‘Urinary tract infection left me housebound’


Women with chronic urinary tract infections (UTI) say the pain can last for years and make it impossible to live a normal life. Some claim the NHS is failing to diagnose and treat the problem, which is leading to severe debilitating symptoms.

Leanne Gray claims that some days her chronic UTI is so painful that she just wants to curl up on the couch.

“It can completely change your life; I’m housebound some days,” she says.

The 40-year-old Aberdeen nurse works in intensive care, but the severe pain and constant need for the toilet has made it difficult for her to do her job at times.

UTIs are one of the most common infections in women, with nearly half experiencing at least one infection in their lifetime.

The majority of people receive treatment, such as a short course of antibiotics, from their doctor or a pharmacy, but for some, the infection persists and they are left in excruciating pain for years.

These women claim that their doctors have ignored them and that they have had to spend thousands of pounds on private treatment.

What are urinary tract infections?

Bacteria, most commonly from their own bowels, enter the urinary tract through the urethra, the tube that transports urine out of the body, and cause UTIs.

Because women’s urethras are shorter than men’s, bacteria are more likely to enter the bladder or kidneys and cause an infection.

Symptoms include burning when passing urine and the feeling of needing to pass urine frequently, as well as fever, shivers, and pain.

Dipstick tests

Leanne has had urinary tract infections since she was a teenager, but in the last few years they have become chronic, and the symptoms have been intractable.

Sending a urine sample to the lab is the most reliable test for UTIs, but results can take days, so GPs frequently use a faster dipstick test, which does not detect many cases, including Leanne’s.

Dr Imran Omar says relying on dipstick testing cannot rule out the possibility of false negative test

According to Dr. Imran Omar, the tests can miss up to half of all positive infections.

“You cannot rule out the possibility of false negative test if you rely on dipstick testing and the patient has symptoms of a UTI,” he says.

“These patients, in my opinion, should be tested further.”

“If the women have symptoms of UTI and it is not picked up earlier and the diagnosis is missed,” says Dr. Omar, “they can develop chronic UTI.”

Leanne tested negative for UTIs on a “dipstick test” with an NHS doctor, and her infection was only confirmed by additional tests after she saw a private consultant.

She is now undergoing treatment that includes long-term high-dose antibiotics.

This treatment is not available on the NHS, but she claims it has helped her symptoms.

“I know there have been women in treatment for four years and they are starting to feel better,” she says, referring to support groups.

“I believe it’s just a matter of finding the right antibiotic combination.”

Dr Catriona Morton warns of the danger of antibiotic resistance

However, Dr Catriona Morton, deputy chair of the Royal College of GPs in Scotland, believes that this approach could have serious consequences.

“We have to be concerned about long-term antibiotic use because it can lead to antibiotic resistance,” she says.

According to Dr. Morton, overuse of antibiotics can reduce their effectiveness for both the patient and society as a whole.

According to the evidence in the NHS Scotland SIGN guidelines, low dose antibiotics are useful but should be used “with caution.”

Patients can be treated with antibiotics for a chronic UTI even if their test results are negative if they present with symptoms, according to the guidelines.

Dr. Morton advises women to return to their doctor if they are still in pain after a standard three-day course of antibiotics.

“We don’t want to see women suffer,” she says. “However, assuming that this pain is caused by a urine infection would be a mistake.”

According to Carolyn Andrew of the Chronic Urinary Tract Infection Campaign (CUTIC), changes need to be made in the way these UTIs are treated and recognised.

She advocates for more effective testing methods and chronic UTI treatment to be made available to everyone.

“The tests are currently unfit for purpose,” she says.

“The existence of chronic UTIs must be acknowledged. SIGN guidelines for chronic UTI do not currently exist.”

She also advocated for more research into the condition.

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